Objective:To quantify outcomes of individuals diagnosed and treated for prostate cancer in a single institution.
Design: Retrospective electronic chart abstraction
Setting: Marshfield Clinic, the largest private multispecialty group practice in Wisconsin and one of the largest in the United States, the clinic provides health care services annually to approximately 385,000 unique patents through 1.8 million annual patient encounters
Participants: Individuals within the MC tumor registry who had been diagnosed with prostate cancer between 1960 and 2009.
Methods: Electronic chart abstraction from the tumor registry and the electronic medical record was conducted (N=6,181), including age of the individual at diagnosis, stage, and grade of the tumor; PSA values before diagnosis, at diagnosis, and after diagnosis; initial cancer treatment; follow-up time; subsequent cancer treatments; evidence of metastasis; age of death; and cause of death if known.
Results: The average age of prostate cancer diagnosis has decreased from 70-71 in the 1960's and 1970's to an average age at diagnosis of 67 in the 2000's (p< 0.001). This decrease in age occurred within the decades of the implementation of PSA screening. Approximately 74% of the men diagnosed with prostate cancer within the PSA screening era had at least one PSA test and the presence of a PSA test did not appear to change treatment outcome. Age, grade, and stage were the biggest predictors of prostate cancer outcome. There was no difference in event free survival between current treatment types (radical prostatectomy, brachytherapy, photon treatment, or IMRT) (2003 or later) when stratified by and age (greater than 85%, 5 year event free survival p=0.85), however more events occurred with older external beam radiation treatment regimes (1993-2003) (70 to 75%, 5 year event free survival p= 0.001).
Conclusion: Individuals diagnosed and treated for prostate cancer, within the Marshfield Clinic comprehensive care setting, follow national trends with a decreased age of diagnosis with the advent of PSA screening. Outcomes for individuals treated within the Clinic system are also comparable to national trends.
Written by:
Cross DS, Ritter M, Reding DJ. Are you the author?
1Marshfield Clinic Research Foundation Center for Human Genetics.
Reference: Clin Med Res. 2012 Apr 25. Epub ahead of print.
PubMed Abstract
PMID: 22537761
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